Health Promotion Networks. Copenhagen, Denmark. 16 October The Health in Prisons Programme HIPP – WHO/Europe’s Network on Prison & Health Stefan Enggist Technical Officer Prison Health World Health Organization Regional Office for Europe

Health Promotion Networks. Copenhagen, Denmark. 16 October The 53 States of the WHO/EURO-Region Albania, Andorra, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Luxembourg, Malta, Monaco, Montenegro, Netherlands, Norway, Poland, Portugal, Republic of Moldova, Romania, Russian Federation, San Marino, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Tajikistan, The former Yugoslav Republic of Macedonia, Turkey, Turkmenistan, Ukraine, United Kingdom of Great Britain and Northern Ireland, Uzbekistan

Health Promotion Networks. Copenhagen, Denmark. 16 October Prison population Worldwide approximately 10 million people imprisoned In the WHO/Europe Region approximately 2 million prisoners Some 6 million people go through prisons of WHO/Europe region per year Russian Federation approximately 900’000 prisoners Andorra approximately 80 prisoners Approximately 5% women

Health Promotion Networks. Copenhagen, Denmark. 16 October Prison population worldwide Number of prisoners per population

Health Promotion Networks. Copenhagen, Denmark. 16 October Prison population in the European Region Number of prisoners per population Source: International Centre for Prison Studies 2011

Health Promotion Networks. Copenhagen, Denmark. 16 October Health in prisons - a matter of Human Rights International Covenant on Economic, Social and Cultural Rights, Article 12: Prisoners are entitled to the highest attainable standard of physical and mental health  UN Standard Minimum Rules for the Treatment of Prisoners  European Prison Rules (Recommendations of the Council of Europe concerning prisons)  European Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (Council of Europe 1987)

Health Promotion Networks. Copenhagen, Denmark. 16 October Principle of equivalence Health policy in custody should be part of the national health policy; Health services should be equivalent to those outside prisons; Medical confidentiality and patient’s informed consent should be guaranteed; Medical staff should operate in complete professional independence of the prison administration (R (98)/7 Council of Europe) Access to care Prisoners must have access to a doctor at any time of imprisonment (R (98)/7 Council of Europe) Sick prisoners who require specialist treatment shall be transferred to specialised institutions or to civil hospitals, when such treatment is not available in prison. (R (98)/7 Council of Europe)

Health Promotion Networks. Copenhagen, Denmark. 16 October  Standards of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) However, regardless of the difficulties faced at any given time, the act of depriving a person of his liberty always entails a duty of care which calls for effective methods of prevention, screening, and treatment. Compliance with this duty by public authorities is all the more important when it is a question of care required to treat life-threatening diseases. (Committee for the Prevention of Torture CPT Standards rev. 2011) An inadequate level of health care can lead rapidly to situations falling within the scope of the term "inhuman and degrading treatment“ (CPT Standards rev. 2011)

Health Promotion Networks. Copenhagen, Denmark. 16 October WHO Health in Prisons Programme (HIPP) „…Prisoners are the community. They come from the community, they return to it. Protection of prisoners is protection of our communities.“ Joint United Nations Programme on HIV/AIDS (UNAIDS) Statement on HIV/AIDS in Prisons

Health Promotion Networks. Copenhagen, Denmark. 16 October HIPP - aims 1.To encourage prisons to operate within human rights and medical ethics. 2.To encourage prison health services to reach standards equivalent to those in the wider community. 3.To reduce prisoners’ exposure to communicable diseases. 4.To encourage cooperation between health systems, NGOs and prison health systems.

Health Promotion Networks. Copenhagen, Denmark. 16 October Member States 44 Member States are actively involved: 18 from Western Europe: Andorra, Austria, Belgium, Denmark, Finland, France, Greece, Iceland, Ireland, Malta, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, Turkey, United Kingdom (England, Wales and Scotland) 16 from Central Europe: Albania, Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Hungary, Lithuania, Latvia, FYR Macedonia, Republic of Moldova, Montenegro, Poland, Romania, Serbia, Slovakia, Slovenia, Kosova/UN Admin. Province of Kosovo (observer) 10 from Eastern Europe: Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Russian Federation, Tajikistan, Turkmenistan, Ukraine, Uzbekistan

Health Promotion Networks. Copenhagen, Denmark. 16 October International partners United Nations Office on Drugs and Crime Pompidou Group, Council of Europe AIDS Foundation East-West European Monitoring Centre for Drugs and Drug Addiction International Centre for Prison Studies, Kings College, London International Committee of the Red Cross KNCV Tuberculosis Foundation Sainsbury Centre for Mental Health, United Kingdom WHO Collaborating Centre for Promoting Prison Health, Department of Health, England and Wales American Public Health Association The Prison Health Expert Group of The Northern Dimension Partnership in Public Health and Social Well-being International Corrections and Prisons Association

Health Promotion Networks. Copenhagen, Denmark. 16 October Steering Group AIDS Foundation East-West Centre for Mental Health Council of Europe – Pompidou Group European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) International Centre for Prison Studies International Committee of the Red Cross KNCV Tuberculosis Foundation The Netherlands Spain UNODC WHO Collaborating centre for Prison Health Department of Health - London

Health Promotion Networks. Copenhagen, Denmark. 16 October Activities WHO HIPP Annual network meeting – October : Copenhagen/Denmark organized jointly with WHO Collaborating Centre for prison and Health, UNODC and ICRC Projects in Member States Best Practice Awards Publications on prison health topics:  Prevention of acute drug-related mortality in prison populations during the immediate post-release period (2010)  Patient or Prisoner: Does it matter which Government Ministry I responsible for the health of prisoners? (2010)  Health in prisons. A WHO guide to the essentials in prison health (2007)

Health Promotion Networks. Copenhagen, Denmark. 16 October Upcoming in 2012/13 Upcoming 2012 Alcohol and prisoners Upcoming 2013 Stewardship for prison health 2 nd edition

Health Promotion Networks. Copenhagen, Denmark. 16 October 2012.

Health Promotion Networks. Copenhagen, Denmark. 16 October Thank you! Contact details: Website: